In plain words
Acute otitis media is an infection of the middle ear, the air space behind the eardrum. It comes on quickly and is common in babies and young children. Signs can include fever, fussiness, pulling at the ear, poor sleep, and poor feeding. Some babies have a runny nose or cough first. Clinicians diagnose it by looking at the eardrum, often with a small light. Many ear infections clear on their own, and some need an antibiotic, which the clinician decides. Breastfeeding is linked with fewer ear infections in some studies, but no feeding choice rules them out. A fever in a baby under 3 months needs a call to the pediatrician right away.
The deeper version
Acute otitis media is diagnosed by the combination of rapid onset, middle ear effusion, and signs of middle ear inflammation on otoscopy, following the American Academy of Pediatrics clinical practice guideline (Lieberthal and colleagues, 2013, Pediatrics). The guideline supports watchful waiting in selected children with non-severe disease, and antibiotic treatment when the diagnosis is certain or the disease is severe. Peak incidence falls between 6 and 24 months. Risk factors include daycare attendance, smoke exposure, pacifier use, bottle feeding in a supine position, and family history. Breastfeeding is associated with reduced incidence in several cohorts. The controversy centers on the balance between antibiotic use and complications, and on whether pacifier and feeding-position advice should be framed as prevention.
Where it comes up
- PacifiersBaby Basics
- Nursing strikes and refusalFeeding Your Baby
- When to call the pediatrician (and when to go in)Baby Basics
What mothers here say about acute otitis media
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Sources
- American Academy of Pediatrics — The Diagnosis and Management of Acute Otitis Media, clinical practice guideline (Lieberthal and colleagues, 2013)